Scientific and policy advances are putting early childhood development (ECD) at the center of efforts to improve human development. This study was undertaken to understand what knowledge and attitudinal barriers exist that hinder the full-scale roll-out of services for the youngest children and their families. We used anthropological methods honed by the Frame works Institute to plumb beliefs about early childhood development among members of the public and implementation and policy stakeholders,and compare those with the findings from ECD research. While members of the public and stake holders agree on the importance of ECD, as demonstrated in other country settings, a major barrier to directing services to the youngest children is a perceptual tendency to ‘age up’. That is, to consider learning and other important skills as being acquired in the pre-school rather than infancy period. Communication strategies that incorporate debate are needed to give full effect to the ECD and related policies, especially around the topics of prioritizing the youngest children, physical punishment, child rights, and the pervasiveness of threats to ECD arising from poverty and disadvantage.
Linda Marleine Richter, Mark Tomlinson, Kathryn Watt et al.
Introduction: Caregivers play an integral role in their child's development. Many caregivers from low resource communities within sub-Saharan countries face challenges in providing early childhood development (ECD) and stimulation. In South Africa, there are policies in place that aim to provide caregivers with child-care support and services; however, systemic factors often negatively impact the service delivery of early childhood development at a community level. This integrative review aimed to analyse, appraise, and synthesise the literature concerning the published evidence of caregivers' perception on their role in early childhood development and stimulation programmes for children within the ECD phase. Method: The integrative review followed the five steps highlighted by Whittemore & Knafl. The literature search was conducted by electronic searching through ScienceDirect, Taylor & Francis, PubMed, JSTOR, Lancet, Google Scholar and Research Gate. Literature was included from 01 January 2010 to 31 December 2020, that were published in sub-Saharan Africa, regarding early childhood development and stimulation. A total of 22 records were included in the review. The data was qualitatively analysed through thematic analysis. The findings are presented according to the Bronfenbrenner's Ecological Systems Theory. Findings: Findings highlight that caregivers' facilitation of early childhood development in their children is influenced by daily practices of child-care and rearing. Caregivers perceived their role as nurturing and disciplining their children. The educational aspect of child development was the role of the school/ECD facility. Among these influences are contextual factors, culture, and poverty, which impact the practices that caregivers implement during early childhood development. There are policies and stimulation programmes in place to support and assist caregivers/parents in facilitating early childhood development. Conclusion: Caregivers' form an integral component in a child's early childhood development and stimulation. The caregiver role is impacted by several factors which include context, culture, awareness of services, knowledge on child development, stimulation and resources. There is poor implementation and knowledge of support structures, policies, and stimulation programmes at a community level. This, therefore, suggests that government departments need to advocate and promote for easier access to facilities to assist caregivers/parents further. Keywords: early childhood development, family support, policies, stimulation programmes, low resource contexts, stimulation.
INTRODUCTION: In South Africa, early childhood development (ECD) in rural areas is challenged by the lack of a centre-based programme and because the ECD practitioners are inadequately trained. The Crosstrainer Programme (CTP) may be a centre-based early childhood development programme that could address this challenge. Consequently, the aim of this study is not to prove, but to determine the level of efficacy of the CTP on the development of three to four year old children in the rural Mahikeng areas METHOD: An experimental trial was conducted. The ECDC (Early Childhood Development Criteria) were used to test the children (49 from 17 ECD centres RESULTS: Both Section A: Cognitive SRRA (School Readiness Risk Areas) and Section B: Fine Motor Coordination were improved by the CTP. However, Section C: Gross Motor Coordination showed no improvement by the CTP CONCLUSIONS: The CTP proved valuable in the improvement of the Cognitive SRRA and even more so on the fine motor development of the population group. It is recommended that activities directed at gross motor development should be increased and amplified in the programme. Further studies on the CTP regarding the development of the children and the occupational enablement of the ECD practitioners are recommended Key words: Early childhood development; ECD; Crosstrainer Programme; CTP; occupational therapy; early learning programme; rural ECD centres; ECD practitioners
Danette de Villiers, Adeleigh Homan, Cornel van Rooyen
OBJECTIVE: To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach. METHODS: We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership. RESULTS: No measure of livestock ownership was significantly associated with children's odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry) was surprisingly associated with decreased child dietary diversity (β = -0.477; p<0.01) relative to owning no livestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; p<0.01), but increasing numbers of chickens were positively associated with dietary diversity (β = 0.022; p<0.01). Notably, neither child dietary diversity nor animal-source food consumption was significantly associated with height, perhaps due to unusually high prevalences of morbidities. CONCLUSIONS: Our novel typologies methodology allowed for an efficient and a more in-depth examination of the differential impact of livestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between livestock ownership and nutrition outcomes-including how livestock are utilized by the target population-when attempting to use livestock as a means of improving child nutrition.
Sarah E. Dumas, Lea Kassa, Sera Lewise Young et al.
Child malnutrition remains a widespread public health problem in sub-Saharan Africa. Providing access to nutritious foods for all is key, but it is not clear how this can be achieved in various local contexts. Here, we analyze the role of markets and food environments for child diets and nutrition in Malawi along a rural-urban continuum. We develop a new methodology to characterize food environments in terms of the variety of fresh and processed foods available in local market settings. Geocoded data of market food variety are combined with individual-level child diet and anthropometric data collected through a household survey. We find large differences in food environments, diets, and nutrition outcomes between urban, rural, and remote locations. The spatially-explicit analysis shows that market food variety is positively associated with dietary diversity and negatively associated with stunting, also after controlling for confounding factors. Strikingly, processed food variety has more favorable associations with child nutrition than fresh food variety, suggesting that lightly and moderately processed foods are important sources of nutrients in the local settings. Our findings stress the importance of improving the functioning of markets for nutritious foods, especially in rural areas. Conceptually, we add to the literature on measuring food environments.
Vivien Hülsen, Makaiko Gonapanyanja Khonje, Matin Qaim
ABSTRACT This study extends earlier work on the determinants of child stunting in Zambia by incorporating 2022 Living Conditions Monitoring Survey data, enabling assessment of nutritional change over a longer post‐policy period. It supplements the earlier paper by using 2022 LCMS data as opposed to 2015, thereby giving a longer period between the policy change and evaluation. We analyze changes in child height‐for‐age z ‐scores (HAZ) in Zambia between 2010 and 2022, aligned with the 2011–2015 and 2017–2021 National Food and Nutrition Strategic Plans. National HAZ improved (Δ ≈ −0.92 SD), with gains in improved water (+26 pp), sanitation (+18.7 pp), dietary diversity (+0.78), and maternal schooling (+0.79); however, crowding (+0.08), the child‐to‐adult ratio (+0.13), and the food budget share (+9 pp) rose. Blinder—Oaxaca results indicate both endowments and returns contributed nationally. Rural areas achieved a smaller gain (Δ ≈ −0.60 SD), driven mainly by stronger returns—especially a steeper HDDS‐HAZ gradient—while endowments changed little. Urban‐dominant areas saw a larger gain (Δ ≈ −1.56 SD) due to both endowments (household structure, food spending) and returns, with the housing‐space coefficient partially offsetting progress. Overall, Zambia's multisectoral approach likely supported broad improvements, but sanitation gaps and urban environmental risks constrained impacts. Priorities: accelerate rural sanitation with hygiene SBC; protect diet quality via food‐system actions and social protection; and strengthen urban environmental health.
Although access to energy is increasingly acknowledged as a cornerstone of sustainable development, its relationship child nutritional outcomes remains underexplored. This gap persists despite well-documented links between child nutrition and related factors such as indoor air pollution, which is one of the many consequences of energy poverty. This study investigates the relationship between household energy poverty and long-term child nutrition, paying particular attention to indoor air pollution as a potential transmission channel. Drawing on nationally representative data from the Malawi Multiple Indicator Cluster Survey (MICS), we examine a sample of 12,139 children under five years of age. Our results indicate that children residing in energy-poor households have significantly lower height-for-age z-scores (HAZ), reflecting poorer long-term nutritional status. Furthermore, energy poverty associates with changes in measures of indoor pollution, supporting the existence of an environmental pathway through which energy deprivation could hamper child growth. These findings underscore the importance of incorporating clean energy access into child health and nutrition policies, particularly in resource-limited settings where energy and health disparities frequently intersect.
Martin Limbikani Mwale, David Eddings Zingwe, Emmanuel Malenga et al.
Aim: To analyse the trends and patterns of stunted only and stunted-underweight children in Malawi between the 2000 and 2015. Methods: The study used the 2000 and 2015 Malawi Demographic and Health Survey data and employed bivariate and multivariate statistical analysis techniques to explore the difference in the levels of stunted only and stunted-underweight children and key socio-economic factors between 2000 and 2015 and identify key attributes of being stunted only and being stunted-underweight. Results: The percentage of stunted only was 37.2% in 2000 and 26.8% in 2015 and the stunted-underweight percentage was 14.5% in 2000 and 8.8% in 2015. Out of the 6.9% children classified as wasted, 2.4% were also underweight and stunted, 2.4% were underweight and 2.1% did not have any other forms of undernutrition. The analysis did not identify any children that were both stunted and wasted. Only 0.7% in 2000 and 0.4% in 2015 were underweight and free of any other forms of undernutrition. There were improvements in mother education level and mother weight during this time-period which may explain the improvements in child nutritional status. Conclusion: The most common form of undernutrition is stunting and nearly all children that are underweight are also stunted. Child nutrition practitioners and health professionals should consider focusing on tackling child stunting.
Namibia has adopted several policies, pieces of legislation and programmes aimed at improving the well-being of children. However, the Namibian National Policy on Orphans and Vulnerable Children (OVC) of 2004 no longer adequately reflects the contemporary problems faced by vulnerable children. Policy makers require a comprehensive and integrated set of indicators to inform policy revision to make informed choices. This article reviewed national and international child protection reports, evaluation studies and indices to identify contemporary indicators for tracking child well-being in Namibia. It found that while the available indicators reflect objective well-being measures, there is a gap in tracking the subjective experiences of children, child safety and the promotion of children’s rights. The article offers an alternative integrated indicator framework that captures multiple dimensions of child well-being. Adoption of this framework can enable policy makers to make more informed decisions to support vulnerable children. Keywords: child well-being, indicator framework, objective well-being, orphans and vulnerable children, subjective well-being
